1. Field of the Invention
The present invention relates to detection of pathogenic bacteria in samples (e.g., clinical isolates and food specimens) for the purposes of diagnoses, screenings, quarantine inspections, and clinical tests. Specifically, it relates to detection of pathogens associated with bacterial food poisoning and bacterial diarrhea. More specifically, it relates to detection of enteropathogenic bacteria including Shigella species, Salmonella species, enterohemorrhagic Escherichia coli or Verocytotoxin-producing Escherichia coli, Staphylococcus aureus, Vibrio cholerae, and Clostridium perfringens.
2. Discussion of the Related Art
Detection of pathogenic bacteria such as Shigella species, Salmonella species, enterohemorrhagic Escherichia coli (hereinafter simply referred to as EHEC) or Verocytotoxin-producing Escherichia coli (hereinafter simply referred to as VTEC), Staphylococcus aureus, Vibrio cholerae, and Clostridium perfringens is an important task in the field of medicine and public hygiene, and various methods have been used.
Conventionally, detection of a pathogenic bacterial strain involves isolation of several pathogenic bacterial colonies and identification of the species of the bacteria by serological or biochemical method.
In the case of Shigella species, this has been achieved by culturing and isolating the target bacterium from specimens of patient stools, food, or the like, using a medium, such as DHL agar or MacConkey's agar, and then further culturing the bacterium using a medium such as TSI agar or LIM agar for the purpose of identification.
In the case of Salmonella species, culture is conducted for isolation of the bacteria from specimens of patient stools or vomits, food or wiping samples, etc., followed by inoculation to TSI agar, SIM medium, VP-MR medium and lysine decarboxylation test medium and subsequent overnight culture at 37.degree. C., to confirm Salmonella species, and the serotype is determined using a commercially available set of antisera against O and H antigens.
EHEC or VTEC has been found to cause hemolytic uremic syndrome in children, as well as food poisoning symptoms, typically hemorrhagic colitis, and stress has recently been placed on detection of this bacterium in clinical tests. In the case of detecting EHEC or VTEC, specimens are patient stools, food, or water samples (drinking water, river water, etc.) collected from the environment surrounding the patient. In detecting EHEC (VTEC) in these specimens, it is necessary to perform a series of procedures from direct isolation culture, a primary confirmation culture test, and a secondary confirmation culture test to an agglutination test with an antiserum.
In the case of Staphylococcus aureus, specimens are patient vomits or stools, food the patient ate, samples wiped out from the environment surrounding the patient, or the like. Before Staphylococcus aureus is detected and identified in these specimens, it is necessary to perform bacterial culture, isolation culture and then pure culture and confirmation culture.
In the case of Vibrio cholerae, specimens are patient stools or food, or water samples (drinking water, river water, sea water, etc.) or benthos samples collected from the environment surrounding the patient. In detecting and identifying Vibrio cholerae in these specimens, it is necessary to perform a series of procedures from primary enrichment culture, secondary enrichment culture, and isolation culture to an agglutination reaction test with anti-V. cholerae 01 serum and confirmation culture.
In the case of Clostridium perfringens, specimens are obtained mainly from patient stools and food. For detection and identification, the specimens are subjected to enrichment culture and isolation culture under anaerobic conditions. With several colonies of the bacteria, tests for biochemical properties are conducted.
Any identification process mentioned above usually takes several days, and hampers rapid diagnoses of infectious diseases.
Specifically, in the case of Shigella species, each culture step takes 18-24 hours, totalling 3-4 days; rapid detection is difficult. Other available methods include the reversed passive latex agglutination using a specific antibody to the Shiga toxin, the EIA method using a specific antibody to the 140 MDal plasmid product associated with the pathogenicity of Shigella species and enteroinvasive Escherichia coli [Kenichiro Ito et al., Japanese Journal of Bacteriology 41, 414 (1986)] and the DNA probe method for detecting the ipaB gene, the ipac gene, or the ipaD gene (U.S. patent application No. 888,194). However, these testing methods require complicated troublesome procedures in preparing reagents and specimens, and take much time.
In the case of Salmonella species, 2-3 days are taken for bacterial isolation and identification of the bacteria from specimens. In addition, Salmonella tests are difficult to conduct in ordinary laboratories, because as many as 100 antisera and much experience are required to achieve complete serum typing of Salmonella species, which involve a large number of serum types. Also, each culture step and serotyping test take 3-4 days; rapidity is poor. Moreover, confirmation culture and serotyping are expensive and involve troublesome operation.
In the case of EHEC (VTEC), each culture step takes 18-24 hours, totalling as many as 3-4 days. The currently representative serotype of EHEC (VTEC) is 0157:H7, but no diagnostic antiserum has been commercially available for identification of this serotype, so that the diagnostic antiserum has to be prepared by the investigator. In addition, it is often difficult to identify the causative bacterium solely on the basis of serum typing in EHEC (VTEC), because the serum type and the pathogenicity do not always agree with each other. Therefore, the conventional testing method for EHEC (VTEC) lacks rapidity and simplicity, and is not suitable for practical application.
In the case of Staphylococcus aureus, each culture step takes 18-24 hours, totalling as many as about 4 days when combined with the time required for the subsequent testings. Also, in the biochemical test in culture for identification, various properties, such as aerobic growth, VP reactivity, nitrate reduction, Tween 80 hydrolyzability, hyaluronidase activity and sugar decomposition, should be examined, but this process is troublesome, tedious and expensive. The most reliable method for identifying the causative bacterium for food poisoning and diarrhea is to test the isolated strain for exotoxin (toxic shock syndrome toxin-1, hereinafter simply referred to as TSST-1) production. However, even when a commercially available convenient reagent kit is used, 18-20 hours will be taken to obtain the results; rapidity is poor.
In the case of Vibrio cholerae, each culture step takes 18-24 hours, totalling as many as about 4 days. In the biochemical test concerning confirmation culture, various properties, such as oxidase test positivity, indole test positivity, motility, and lysine decarboxylation test positivity should be examined. These tests are troublesome, tedious and expensive, and the results obtained are difficult to assess in some cases. Moreover, in the case of Vibrio cholerae, it is essential to test the isolated strain for enterotoxin (cholera toxin; CT) production to take an administrative measure for pest control. However, even when a commercially available convenient reagent kit is used, 18-20 hours will be taken to obtain the results; rapidity is poor and practical applicability is low.
In the case of Welch's bacillus(Clostridium perfringens), the detection requires considerably long time: each culture step takes 18-48 hours, totalling 5-6 days. In addition, since Clostridium perfringens strains are widely distributed in the nature, only the detection of the bacterial strain from specimens is not enough to determine the strain as the causative agent for food poisoning. Further tests are required, including detection of the enterotoxin in patient stool, assay of the isolated strain for enterotoxin production, serotype determination, and bacterial count for suspected food. These procedures consume much time and labor, and lack rapidity and simplicity.
In recent years, the DNA probing or hybridization using oligonucleotides has been tried. However, when hybridization is performed on a membrane or on other supports using a probe of a labeled oligonucleotide, followed by detection of the probe, sensitivity of the assays depends on numbers of organisms available for detection. Therefore it is difficult to achieve a high detection sensitivity and selectivity in this test without the above-described pretreatment of the separation culture.